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人偏肺病毒导致的大叶性肺炎:一例病例报告。

Lobar pneumonia due to human metapneumovirus: a case report.

机构信息

Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.

Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central Hospital, Kurashiki, Okayama, Japan.

出版信息

Int J Infect Dis. 2024 Sep;146:107162. doi: 10.1016/j.ijid.2024.107162. Epub 2024 Jul 3.

Abstract

Human metapneumovirus (hMPV) is a respiratory pathogen that can cause lower respiratory tract infections and pneumonia in immunocompetent adults. Pneumonia caused by hMPV is reportedly more likely to cause bronchial wall thickening and ground-glass opacity (GGO). A 44-year-old woman with no significant medical history developed fever, cough, and nausea. Computed tomography of the chest showed scattered GGOs in the right upper lobe and infiltrating shadows with air bronchograms in the left lingual and bilateral lower lobes. The patient was admitted to our hospital for further evaluation. Atypical pneumonia was suspected and lascufloxacin (LSFX) was started. Multiplex polymerase chain reaction (PCR) detected hMPV on hospital day 2 using the FilmArray Respiratory Panel 2.1. Pneumonia due to hMPV was suspected and LSFX was discontinued. The patient subsequently showed spontaneous improvement and was discharged on hospital day 6 after admission. After discharge, pneumonia continued to improve. Early detection of respiratory pathogens using multiplex PCR can help determine the appropriate treatment strategy. As hMPV can also cause lobar pneumonia, we should consider pneumonia due to hMPV in the differential diagnosis of lobar pneumonia.

摘要

人偏肺病毒(hMPV)是一种呼吸道病原体,可导致免疫功能正常的成年人下呼吸道感染和肺炎。据报道,hMPV 引起的肺炎更可能导致支气管壁增厚和磨玻璃影(GGO)。一位 44 岁的女性,无明显病史,出现发热、咳嗽和恶心。胸部计算机断层扫描显示右上叶散在的 GGO 以及左舌叶和双侧下叶的浸润影伴空气支气管征。患者因进一步评估收入我院。疑诊为非典型肺炎,并开始使用左氧氟沙星(LSFX)。采用 FilmArray 呼吸道 Panel 2.1 在入院第 2 天进行多重聚合酶链反应(PCR)检测到 hMPV。疑诊为 hMPV 引起的肺炎,停用 LSFX。患者随后自行好转,入院后第 6 天出院。出院后,肺炎继续好转。使用多重 PCR 早期检测呼吸道病原体有助于确定适当的治疗策略。由于 hMPV 也可引起大叶性肺炎,因此在大叶性肺炎的鉴别诊断中应考虑 hMPV 引起的肺炎。

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